Current opinion in organ transplantation · 2025
Ethics of managed care in renal transplantation: the principal approach and alignment of incentives create an ethical system.
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Holzner Charles, Ramos Hector C
Аннотация
PURPOSE OF REVIEW: Organ transplantation is a vital medical procedure that saves and extends lives. However, it requires a careful balance of resources, which are often limited by managed care constraints. Renal transplantation is the definitive treatment for patients with end-stage renal disease (ESRD). We share our experience with a managed care organization and how it upheld ethical principles while maintaining solvency and cost-effectiveness.
RECENT FINDINGS: Managed care organizations are pervasive healthcare entities and highly regulated businesses. To remain solvent, patients must join them and be satisfied with the care, or they will switch to a competitor. Most programs currently use the comprehensive risk-based managed model, consistent with federal regulations.CareMore in California, established in 1992, provided care to patients with ESRD. Services were based on ethical principles and alignment of incentives. An unsuccessful program or one fraught with complications is a major financial loss. The program was designed to ensure a positive outcome, aligning the incentives of providers, patients, and the program. As a result, the program was solvent, efficient, and ethical.
SUMMARY: In conclusion, moral critiques of managed care plans overlook the benefits for individuals and society. The eventual advantage to healthcare and the individual is assured when principles and incentives are aligned.
RECENT FINDINGS: Managed care organizations are pervasive healthcare entities and highly regulated businesses. To remain solvent, patients must join them and be satisfied with the care, or they will switch to a competitor. Most programs currently use the comprehensive risk-based managed model, consistent with federal regulations.CareMore in California, established in 1992, provided care to patients with ESRD. Services were based on ethical principles and alignment of incentives. An unsuccessful program or one fraught with complications is a major financial loss. The program was designed to ensure a positive outcome, aligning the incentives of providers, patients, and the program. As a result, the program was solvent, efficient, and ethical.
SUMMARY: In conclusion, moral critiques of managed care plans overlook the benefits for individuals and society. The eventual advantage to healthcare and the individual is assured when principles and incentives are aligned.